Factors associated with dental service utilization among long-term care insurance recipients: analysis of the national elderly cohort database

Objectives: This study examined dental care utilization among older adults who use long-term care (LTC) insurance and identified sociodemographic and LTC-related factors associated with dental care utilization.Methods: This cross-sectional study analyzed the 2019 data from the National Health Insurance Service-National Elderly Cohort Database.We examined the data of 50,606 beneficiaries aged 60 years.Stepwise multiple logistic regression was performed to identify the impact of sociodemographic and LTC-specific factors on dental service utilization. Results:The dental care utilization rate was 29.4%.Higher utilization was significantly associated with male sex, younger age, urban residence, higher income, and disability.Notably, LTC characteristics were strong predictors of dental service utilization: home-based care users were 2.26 times more likely to use dental services than facility-based users (OR=2.26,95% CI: 2.11-2.43).Utilization significantly decreased with higher LTC severity (grade 1; OR=0.22).Dental utilization was higher when a spouse was the primary caregiver but lower when care was provided by paid caregivers.Conclusions: Dental care utilization among LTC recipients is constrained by structural factors, including benefit types and caregiving environments.Policy efforts should focus on institutionalizing home-visit dental services and enhancing caregivers' oral health competencies within the LTC system.